by Nicolas Hulscher, MPH

Hypertensive disorders of pregnancy are major drivers of preterm birth, emergency delivery, seizures, stroke, organ injury, long-term cardiovascular disease, and maternal and fetal death.

A newly published CDC registry study using data from the CDC’s COVID-19 Vaccine Pregnancy Registry (C19VPR) and the Pregnancy Risk Assessment Monitoring System (PRAMS) compared approximately 8,000 vaccinated pregnant women to 8,000 unvaccinated pregnant women and found a 24% higher relative risk of hypertensive disorders of pregnancy (15% vs. 12%) among those who received COVID-19 shots. These disorders — which include gestational hypertension and preeclampsia — are a leading cause of maternal and fetal death worldwide. The association was statistically significant, persisted in sensitivity analyses, and remained after adjustment for multiple confounders.

The absolute difference observed was 3 percentage points. That means roughly 1 additional case of hypertensive pregnancy complications for every 33 vaccinated pregnancies. If even 40–60 million pregnant women worldwide received COVID-19 vaccination during the global rollout period, a 3% absolute increase would translate into an estimated 1.2 to 1.8 million additional cases of hypertensive pregnancy complications globally.

Hypertensive disorders are not benign. They increase the risk of preterm birth, NICU admission, emergency induction, C-section, long-term maternal cardiovascular disease, and in severe cases, maternal and fetal death. Even in well-resourced settings, these conditions significantly alter pregnancy outcomes.

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